I haven't said this in years, but please would you help with my (CBT) homework?

Pleased to meet you too Felineaut and glad to hear that you are not too far from where you want to be, also thanks for challenging some of the thinking in the thread. The RCPsych reference contains some content that has perhaps evaded some of the therapists that have been discussed on the thread.

CBT is not just a talking therapy, it is not a nice chat over a cup of tea! There will be therapists who don't get this but there will also be people who haven't heard this from their therapists. Sometimes we are bad at listening and sometimes people are not good at explaining things. Autistic people are at a disadvantage in such conversations but it is no less shocking that someone can take a patient along for so long without getting the basic and crucial ideas behind CBT across to the patient. Autism is hard to spot and diagnose and I'm not altogether surprised that a CBT therapist might miss this. There are many people on the forum who have had highly qualified Psychiatrists and Psychologists fail to diagnose them. Spotting the signs of autism through a cloud of consequential, or simply concurrent, comordities is not straightforward.

Two ideas stand out from the RCP slides.

1) Challenge. You have to learn to challenge your thinking and your reflexes. You have to learn that it is possible to change your mind about things. You have to learn that we may be more rigid than many people but our minds are not set in stone.

2) The Socratic method. This is all about picking things apart to work out what is really going on. It is about not accepting things because they have always been that way. Progressively refining your thoughts about something and listening to other people's contributions and learning to unpick their arguments and preconceptions and working towards a true and fair view of a situation rather than listening to your prejudices.

These approaches should be taught, to the subject, by the therapist using examples to bring the techniques to life. This teaching can be a mixture of training and education but it is better if the subjects understands why rather than just learning how, parrot fashion.

A previous manager at a previous organisation labelled me as Socratic long before I got my diagnosis. I had no idea what this meant so I read Plato's Republic. This explains what Socrates was about but also explained what an irritating person he was. So irritating and persistent with his challenges that he was put to death! So irritating and persistent that he strikes me as probably autistic. His lack of diplomacy and persistence of detached analysis struck a chord with me. I know that this diplomatic deficit means that I won't ever be a successful politician but I can learn to take the more abrasive traits in hand as well as I can.

NAS18906 said:

[quote][/quote]

These therapies are designed by NTs, for NTs. They are in no way reflective of the way that we think, read or respond to situations. It's all very well saying to, for instance, Longman, that in that situation you could have done xyz abc etc, this is, after all, the basis for social stories, but remembering to relate a theoretical situation discussed in the calm of a non-threatening place with a real-life scenario is vastly different. This is one of many instances where NTs don't, and cannot, 'get it'. The false premise is that we can change the way we think - you might as well say that we can train NTs to think, feel and react the same way that we do. Preposterous.

This makes it sound as though NT's think one way and we think in a different way. We have different strengths and weaknesses but there are many different personality types and thinking styles within NTs and people with autism do not all think in a single way. We tend to be more isealistic and less constrained by convention, we tend to think laterally rather than trotting things out parrot fashion but we have more in common in thinking styles and thinking ability with NT's than we sometimes think. We are capable of being trained and also of being educated. i.e. we can learn the rules and we can learn to understand why things happen. We are capable of creative thought and invention - just as NTs are capable of the same things. It is clear from reading the threads on this forum that there is not unanimity of thought among us. Indeed, I find it harder to deal with other AS people that I have worked with than NTs. The problem is that when you put two people with communication problems together the opportunity for misunderstanding is actually greater than if you put an AS person with an NT person.

I think there is an issue of dividing the world into them and us. People talk as if there is almost a conspiracy of NTs against people with autism. They don't understand us, that is true. But we don't understand them either. Who is most at fault in holding on to prejudices and fixed ideas? Actually, we are the ones that struggle with rigidity of thought! But, rigidity of thought does not mean that we are incapable of learning new things and new ideas about how to deal with our problems. It may be harder and we will never get rid of the autism or the barriers that it creates for us but I think we should be deliberately open minded to trying things, like CBT, that might help. I would much rather try CBT than drugs and I don't see much alternative.

There is a destructive tendency in some of these posts to criticise everything without suggesting a useful alternative. People with AS tend to be critical thinkers who can pick things apart and find the faults. I know that I have been guilty of this at times. We are perhaps less good at being more constructive and accepting that something, even with some faults, is better than doing nothing. This leaves people like the OP with the impression that their situation is totally hopeless and that there is nothing to be done. CBT has had real benefits for some people on this forum. These people have often found that it is effective when drugs have failed. Nobody claims that CBT will cure autism, what it can do is make life better, with less anxiety and depression than before.

The OP came looking for advice on how to tackle an assignment and to help with getting more out of CBT. The impression I have is that most people who have contributed have dismissed the whole idea of CBT but no-one has suggested anything better or even many words of encouragement. How do you think that approach makes the OP feel?

This left me in bits. What a wonderful post. Thanks! I am fine, anxiety but no depression thank goodness but to anyone out there in a dark place, hang in there, be kind to yourself.

I particularly liked the comment about dividing the world. I'm recently diagnosed so haven't had time to carve my world into slices! What I know so far is that people are complicated, all in different ways. That's true of NT and ND and I won't be participating in any blame games. Same's true of gay/straight, creating barriers just makes for more tensions.

Also I feel I must confess the situation wasn't hypothetical. It happened to me. My practitioner is data gathering with me, what I consider a very Asperger friendly approach. In fact she was of the opinion that my reaction was fairly normal (for a NT or ND person) , so she's certainly not a bad cop in this tale.

recombinant socks, I'm very pleased to make your acquaintance. 

Wow. I had no idea so many people would respond, or that this question would be as contentious as it appears to have been. I didn't intend to light a touch paper and then retreat, I was busy at the weekend then it took me a day to read through all the posts that had been written.

Thanks to everyone who chipped in, I found the responses interesting, challenging and very enlightening. We have all had different journeys and experiences and that's very clear from the diversity of opinions on various types of therapy.

I certainly don't feel that I need to justify or defend my choices, they're mine and I make them. I have been seeing a CBT person to better learn how to cope with the ever present stress and anxiety I experience. She is not an 'Autism' CBT person but she is smart and listens and challenges me gently whilst helping me to cope better. I chose to do this because I walked out of my job earlier this year and realised that I need to make some changes to my life. CBT started before I got my diagnosis, has continued unchanged despite the unequivocal diagnosis of Aspergers. It seems that people have different ideas about what CBT means. For me it is not TA, nor is it dredging up all of the past. I choose what to bring up or not. The closest explanation of how I understand/experience CBT that I've found is here (hope it's ok to post that link) www.rcpsych.ac.uk/.../5 Blenkiron W2 IC2013.pdf

I am not naive about the dangerous effects of poorly informed therapists. As a young gay teenager I experienced exactly how understanding mental health services could be - and I wasn't even the one in the service! So I don't underestimate the power of a bad experience to affect future perceptions. However I choose to have an open mind where I can and I can't know if this will help me or not unless I try it. CBT isn't something that happens to you, you use it to do what you want so it can only work as well as you believe it will.

i wish I could respond to more of the posts individually but right now I'm all out of spoons so I shall instead wish you all a good evening.

Hi Classic Codger and Longman,

We'd like to remind you that swear words are not allowed in this Community and we also make it quite clear that surveys are not appropriate. 

We'd also like to point out the tone of your posts is becoming quite judgemental, critical and negative at points. We'd like you to keep the tone positive and constructive and stear away from personal attacks.

Volunteer moderators (some of which are on the spectrum themselves) give up their time to maintain this community and without this having a community would not be possible. 

I ask you to be aware of this when commenting in future. This is forum for people to get support and advice about autism and it should remain a positive space.

Take care,

Avi

Hi CC,

My experience has been practically the same :(

Yes, I feel like I too have had a (very expensive) lesson in " it's all my fault" along with the accompanying shame and self loathing .  I realised when I spoke to my only friend (NT) and her partner (possibly AS) that they had more insight and help in an hour than those 20 weeks.  They questioned me on why I felt it was my fault and argued to the contrary.  It was a small step forward but I realised that I was wasting my time with the "specialist" as she had never once questioned my logic or said anything that made me question myself.  I realised that by her just listening and accepting what I was saying was not instigating self acceptance in me but convincing me that I must be wrong to feel like this.  My friend said the most inciteful thing to me which made me realise how differently I think to her, she said that she feels so much better talking to someone and getting it off her chest.  I then realised that it doesn't make me feel better and that I need help and guidance and solutions.

I am angry at myself for wasting thousands of pounds on the specialist with no understanding.  This seems to be such a fundamental difference that she has been unable to grasp despite having a PhD in  Autism.  

And so, back to square one...

Hi gojojo

My answer to your question is No, my experience was the same as yours. I always had far more insight into myself than she had (although this was pre-diagnosis) and it seemed to me that she just got impatient with me and thought that I simply wasn't trying. She could never accept me telling her about the increasing turmoil inside me that the process was catalysing. If anything, it set me up to conflict with myself even more than I'd ever done.

It had terrible coinsequences for me (apologies, it's too raw and emotional to describe just now), was wholly innapropriate, caused permanent damage, and as usual, took no responsibility. All I got was that as a qualified expert, she knew more than me so it was 'all my fault'.

Yes, we get used to it being all our own fault, don't we...?

Hi,  I'm really fascinated by how people have responded to therapy.  I am a 42 year old woman diagnosed last year with aspergers.  I've just fired my therapist who is reconnended by NAS as an autism specialist.  She is the second one I've found to be utterly useless.  I've had 20 sessions.  Apparently she seems to think that just talking is the answer to my problems.  I'm wondering, what input have your therapists had?  It seems from the top of the link that they have tried to instigate some form of change.  Has this helped in anyway, at all?  I've explained to the one I've fired that talking has no benefit to me I have insight into my problems but don't know how to resolve them.  Is this common?

I have also found that she has absolutely no way of being able to relate to how devastated I feel about the diagnosis which has led me to severe depression.  She cannot even understand how it has affected my self confidence, ruined my chance of ever finding a job again etc.  and, apparently she is an "expert" in adult autism! 

has anyone found any form of therapy effective?

Well, the word I used was four-letter vernacular for feacal matter, and I'd be most surprised if any grown-up in Britain doesn't use the word or understand that, within the context, it is an expression of shock, nothing more.

Clearly, some poor sensitive soul was offended and reported it. As we know from experience, even when we report something as dangerous as one of those 'surveys', the mods don't respond with alacrity. They can get 'offended' by a tiny, commonly used and barely offensive word, but they don't mind leaving a window of opportunity for the exploitation of vulnerable people.

That's why I call them the unsane ones, but as they're currently running the asylum, not much we can do about it.

For the moment...

On a different note, we've yet again gone off on a tangent on this thread, probably as a result of the strength of our feelings, beliefs and opinions.

felineaut, have you picked up anything useful, and was it relevant to your original post? We'd like to hear more from you!

Hi longman,

The starred part of the post is not what I removed. When I remove content I put [removed by mod] in square brackets.

Sofie Mod

Reassuring to know our posts are read with so much attention to detail. I did eventually find the stars. Do we have to use phrases like Mr Clever (well clearly not clever ****) or smarty pants in such a context?

Hi classic codger,

I've removed a swear word from your post due to community rules.

Sofie Mod

No problem.

My workplace offered free counselling through a third party organisation so I took this up and got six free sessions. It was my choice but there was no other help on offer. They were a waste of time but at least I wasn't paying!

Sorry, Electra, I lost track of what question you were responding to and I wasn't clear enough in asking "if you needed help now, then do you think that TA or CBT would be more successful in light of your diagnosis?"

I also think that it's unfair to be pushed into therapy because you are being bullied. But that's a topic for another thread perhaps.

I would possibly agree about the OP but you specifically asked about me and I replied as such.

I think it's fair to assume that the OP isn't feeling wonderful about their autistic life at the moment. CBT isn't used to cure autism. It is used to restore someone to a more balanced, less anxious mental state than they have got into. That doesn't mean erasing the autism and turning you into an NT, that just won't happen.

To answer the question, now that I know I'm autistic I wouldn't seek therapy.

There are only a tiny number of therapists of any sort who are experienced in working with autistic people and who understand our ways of thinking. Conventional therapies seek to return one to as 'normal' a state as possible, which for me would be a million miles from my true and wonderfully autistic self.

It would be true if autism was just a different way of thinking

classic codger said:

These therapies are designed by NTs, for NTs. They are in no way reflective of the way that we think, read or respond to situations. It's all very well saying to, for instance, Longman, that in that situation you could have done xyz abc etc, this is, after all, the basis for social stories, but remembering to relate a theoretical situation discussed in the calm of a non-threatening place with a real-life scenario is vastly different. This is one of many instances where NTs don't, and cannot, 'get it'. The false premise is that we can change the way we think - you might as well say that we can train NTs to think, feel and react the same way that we do. Preposterous.

This makes it sound as though NT's think one way and we think in a different way. We have different strengths and weaknesses but there are many different personality types and thinking styles within NTs and people with autism do not all think in a single way. We tend to be more isealistic and less constrained by convention, we tend to think laterally rather than trotting things out parrot fashion but we have more in common in thinking styles and thinking ability with NT's than we sometimes think. We are capable of being trained and also of being educated. i.e. we can learn the rules and we can learn to understand why things happen. We are capable of creative thought and invention - just as NTs are capable of the same things. It is clear from reading the threads on this forum that there is not unanimity of thought among us. Indeed, I find it harder to deal with other AS people that I have worked with than NTs. The problem is that when you put two people with communication problems together the opportunity for misunderstanding is actually greater than if you put an AS person with an NT person.

I think there is an issue of dividing the world into them and us. People talk as if there is almost a conspiracy of NTs against people with autism. They don't understand us, that is true. But we don't understand them either. Who is most at fault in holding on to prejudices and fixed ideas? Actually, we are the ones that struggle with rigidity of thought! But, rigidity of thought does not mean that we are incapable of learning new things and new ideas about how to deal with our problems. It may be harder and we will never get rid of the autism or the barriers that it creates for us but I think we should be deliberately open minded to trying things, like CBT, that might help. I would much rather try CBT than drugs and I don't see much alternative.

There is a destructive tendency in some of these posts to criticise everything without suggesting a useful alternative. People with AS tend to be critical thinkers who can pick things apart and find the faults. I know that I have been guilty of this at times. We are perhaps less good at being more constructive and accepting that something, even with some faults, is better than doing nothing. This leaves people like the OP with the impression that their situation is totally hopeless and that there is nothing to be done. CBT has had real benefits for some people on this forum. These people have often found that it is effective when drugs have failed. Nobody claims that CBT will cure autism, what it can do is make life better, with less anxiety and depression than before.

The OP came looking for advice on how to tackle an assignment and to help with getting more out of CBT. The impression I have is that most people who have contributed have dismissed the whole idea of CBT but no-one has suggested anything better or even many words of encouragement. How do you think that approach makes the OP feel?

These therapies are designed by NTs, for NTs. They are in no way reflective of the way that we think, read or respond to situations. It's all very well saying to, for instance, Longman, that in that situation you could have done xyz abc etc, this is, after all, the basis for social stories, but remembering to relate a theoretical situation discussed in the calm of a non-threatening place with a real-life scenario is vastly different. This is one of many instances where NTs don't, and cannot, 'get it'. The false premise is that we can change the way we think - you might as well say that we can train NTs to think, feel and react the same way that we do. Preposterous.

So, going back to the original questions:-

1. I'd feel threatened, isolated, alone and confused. I'd be astonished by the rudeness, and I'd be bewildered, totally.

2. I'd stand there paralysed whilst my head ran through all of this confusion. My adrenalin levels soaring, I'd end up trembling, legs weak, heart pounding. I'd probably end up punching the guy if I had no escape route.

3. If you're feeling helpless and upset, that would be perfectly reasonable. Most of that would come from your physiological response anyway, and you'd have no control over that whatsoever.

4. I wouldn't 'come down' from that, it would lodge in my memory and I'd keep replaying the situation over and over, I'd imagine different ways that it could have gone, and then I would conclude that we'd be better off killing all NTs so that we don't have this sort of crap in our lives all the time. It would disturb me hugely, I'd certainly lose sleep because the episode would be lodged in my head like a recording loop that won't stop playing.

It's easy to be a smart***e about these things when you're detached from them. I love theroeticians who sit there saying 'you should have, could have...' but none of that matters at the time.

Pardon me if I use a flying analogy - this is within my experience. It's easy to sit on the ground and theorise about what you'd do if an aileron broke in mid-air, but it would be vastly different if you were up there and one broke, because your first thought would be 'this has gone beyond my ability to control it' although actually your only thought would be '[removed by mod] Bail Out!'.

And you would...

Once you're back safely on the ground, you'll hear all sorts of theories from smarties about what you could have done, but it's altogether a different matter once you're safely on the ground and the wreck of your glider is lying in a field without you dead in the cockpit. And my view would be 'I'm here to discuss it, so above all I did the right thing for me'. And that's the point, really.

electra said:

TA and CBT can perhaps help if adapted to autistic people but straight out of the packet they aren't much use to most of us.

The starting point scenarios for the discussions can be the same but the sessions will progress differently with autistic people. The central point though, that people benefit from being challenged or provoked into trying to respond to situations with more thought than reflex, applies equally to autistic and non-autistic people. Both the therapist, and the patient should make allowance and change tack in the light of the subjects autism diagnosis but the autism does not destroy the patients cognitive faculties. 

Electra, now that you know that you are autistic, do you think that a session where both you and the therapist knew you were on the spectrum would be more successful than the previous sessions?